Newsworthiness is considered a plus for a documentary–proof of a subject’s vitality. Still, there are some movies you watch wishing they weren’t so damnably topical. They indict the moment they live in by being so very alive.

Syrian filmmaker Feras Fayyad’s gutwrenching new documentary THE CAVE is such a work. Shot against the backdrop of the Syrian Civil War between 2016 and late 2018, Fayyad’s THE CAVE quite consciously mirrors the unnerving immediacy of his masterful 2017 Oscar nominee LAST MEN IN ALEPPO. It is another chronicle of compassion in a context of living hell.

In LAST MEN, Fayyad and his crew, at great personal risk, rushed into the streets of what was then Syria’s largest city as it quite simply ceased to exist under the horrific air and chemical weapons campaigns launched against unarmed civilians by the Russians and their Syrian proxy President Bashar Al-Assad. Lin LAST MEN, Fayyad’s subject was small heroisms set against unrestrained and industrialized violence, with three untrained volunteer medics called “White Helmets” rushing into the mangled rubble of a city under siege to extract the wounded, the dead and the dying, and to provide comfort where they can.

THE CAVE chronicles the life cycle of an underground hospital in Ghouta, an anti-Bashar suburb on the edge of Damascus, where a five years long siege the U.N. has labelled as “war crimes” and “the worst siege in recent human history” is underway. Here the wounded are delivered with clockwork regularity and by hand. 

There are no anesthetics left in The Cave, and almost no medicines. But thirty year old female pediatrician and hospital manager Dr. Amani Ballour and her cheerful crew do what they can, playing music through an iPhone to take their patient’s mind off their pain as they improvise EMT surgeries, attend to grievously wounded children, and comfort the endless throngs of orphans and next of kin who crowd their cramped and ill-equipped facility, begging for any kind of relief.

Amani is another of Fayyad’s heroic Angels of Mercy, trying to mitigate a cycle of carnage that feels as automated as a factory, as ceaselessly cyclical as an ocean tide. But she differs from the gruff and macho blue collar men of the White Helmets in that she is educated, self-aware and forced by the medieval notions of gender surrounding her to constantly wage a secondary struggle to simply do her job.

Fayyad sets up this subplot early, when a young man begging Amani for medicine she does not have suddenly rounds on her and tells her she should send him a man who can do the job better to solve his problem. This random citizen’s toxic sexism is so unmitigated and direct it makes you gasp: women should be at home, their function is to stay quiet and raise children etc. Even when a male surgeon informs this man that Amani was twice elected by all of the staff to run things because she is by far the best at it, the man refuses to believe him, and storms out, preferring to preserve his sexist outlook over the possibility that some other solution can be found to spare the life of his wife.

As things worsen for Amani and the citizens she and her staff serve, Amani pays a house call to a woman whose face is entirely obscured by a niqaab–the black veil worn in conservative Islamic households–and whose three children are starving before her eyes. Desperate to find a way to save the children, Amani offers the woman a job at the hospital, saying, “If I offer you a job will you take it?” And the woman says quietly, “You know I cannot,” because according to the diktats of her religious beliefs, women are not allowed to work outside the home. Again, enforced gender expectations prove stronger than familial responsibility, and even maternal love. 

Fayyad (who had to direct much of THE CAVE remotely when he was denied access to Ghouta, presumably because of the notoriety of LAST MEN IN ALEPPO) once again proves himself to be an adept disciple of the great Direct Cinema masters like Frederick Wiseman and Jean Rouch, a patient behavioralist who embeds his cameras in an impossibly dangerous context and then lets moments of horror and human gracenotes fall in place with a delicacy all the more remarkable considering the war torn context. The film is at times quite painful to watch, but Fayyad manages somehow to protect the small and flickering flame of his own admiration for Amani and her crew, and for this reason, there is almost always light in the darkness.

Amani’s ongoing personal struggles are punctuated by scenes of staggering drama as the ceaseless sound of bombs battering the neighborhood are followed again and again by the arrival of fresh wounded and new horrors. The conventional weapons injuries are harowing enough. But then, in a scene so terrifying it had the audience I saw the film with whimpering and crying out, a new kind of mass injury suddenly invades the Cave. “It doesn’t make sense,” a nurse says. “People are dying, but they aren’t even injured.” It’s then that they recognize the smell on the vicitms’ clothing, and the lung-ravaging symptoms of chlorine gas.

As children writhe, twitch and gasp, their skin blistering under the exact kind of chemically induced suffering the Obama administration once emptily referred to as the “red line” that would produce a decisive American response against Al-Assad, it’s possible to feel a rush of anger at America’s half-hearted and dithering contributions to the carnage Fayyad has captured with his camera and laid out on screen. It’s an anger THE CAVE doesn’t allow itself–as an artist, Fayyad has chosen the very important imperative of bearing witness, and he does so brilliantly.

But for an informed viewer, the quivering skeleton of American responsibility skulks just out of frame, shuffling along in a grim danse macabre with all the other geopolitical players implicated by the blood-stained “collateral damage” that makes up the Syrian “facts on the ground.” On the night I watched THE CAVE, the Trump administration was celebrating what it was claiming as its successful hand-off of America’s Syrian bases to Al-Assad and the Russians–the very architects of the war crimes and atrocities Fayyad has depicted onscreen.

It’s tempting to call such conflicts as the civil war in Syria intractable. But it’s impossible to shrug while flinching, as amply demonstrated by all the harsh truths THE CAVE so rivetingly inhabits and brings to light. May this film be widely honored, and thereby widely seen.